Coronary bifurcation bench test using multimodality imaging: Impact of stent strut link location on stent deformity and jailed side-branch orifices during re-proximal optimizing technique
Coronary bifurcation bench test using multimodality imaging: Impact of stent strut link location on stent deformity and jailed side-branch orifices during re-proximal optimizing technique
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DOI：
10.1002/ccd.27719
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发表时间：
2019-01-01
影响因子：
2.3
通讯作者：
Uemura, Shiro
中科院分区：
文献类型：
--
作者：
Kume, Teruyoshi;Yamada, Ryotaro;Uemura, Shiro
本研究的目的是在离体实验环境中比较在有和没有支架连接的侧支（SB）口分叉病变之间进行重复近端优化技术（re-POT）序列后支架变形、支架支撑物在被关侧支（SB）口阻塞以及支架支撑物错位。方法采用柔性氨基甲酸乙酯冠状动脉分叉台模型，采用re-POT序列从主支（MB）交叉单支植入术。在内镜观察下，故意设置SB口远端半圆支架连接存在（连接组，n = 12）或缺失（无连接组，n = 12），并通过4种不同支架平台的远端细胞进行重新连接。结果有连接组和无连接组在重新连接后的错配支率和SB监禁率无显著差异。在第二次POT过程中，SB监禁率从8.0%显著增加到9.6% （P < 0.001）。不同支架平台间第二次POT手术后SB监禁率存在差异。结论支架连接在SB口的存在与re-POT序列后的错配支撑率和SB监禁率无关。第二次POT手术后SB入狱率显著升高，但不同支架平台间存在差异。Xience支架可以最大限度地减少SB监禁比的变化，适合于采用re-POT序列进行冠状动脉分叉支架置入。
Objectives The purpose of this study was to compare the stent deformation, obstruction of stent struts at a jailed side branch (SB) ostium, and stent strut malapposition after a repetitive proximal optimizing technique (re-POT) sequence between bifurcation lesions with and without stent links at SB ostia in ex vivo experimental setting. Methods A flexible urethane coronary bifurcation bench model was used, and crossover single stent implantation was performed from main branch (MB) with re-POT sequence. Under videoscope observation, presence (link group, n = 12) or absence (no-link group, n = 12) of stent link at distal semicircle of SB ostium was intentionally set, and rewiring was performed through distal cell in four different stent platforms. Results There were no significant differences in the rate of malapposed struts and in SB jailing ratio after the re-POT sequence between the link and no-link groups. SB jailing ratio increased significantly from 8.0% to 9.6% during the second POT procedure (P < 0.001). SB jailing ratio after the second POT procedure differed among stent platforms. Conclusions The presence of a stent link at an SB ostium was not associated with a rate of malapposed struts and SB jailing ratio after the re-POT sequence. SB jailing ratio was significantly increased after second POT procedure, but was different among stent platforms. The Xience stent might minimize the change of SB jailing ratio and be suitable for coronary bifurcation stenting using re-POT sequence.